Data input or typing errors are frequent causes of medical billing errors. The problem is that a medical billing error might be the difference between getting paid or not. Simple errors are easier to occur; human error must be accounted for; nonetheless, wasted costs can severely drain a healthcare facility’s resources. It is up to the medical billers who work hard to keep errors to a minimum. Along with this, excellent communication may go a long way toward ensuring that these mistakes are stopped before they become an issue.
Why Is It Important for Your Medical Practice to Reduce Medical Billing Errors?
Medical billing errors can have several negative impacts on your practice. The higher rejection rates are the most evident issue. Your practice’s insurance payments will inevitably decrease if claims are consistently denied. Given that many methods run on slim profit margins, even a tiny increase in claim denials might endanger your company. Not to mention the time and effort needed to resolve the refused claim. A bill initially denied due to an error typically takes twice as long to process, and the time spent following up on it prevents you from developing your practice or providing services.
Speaking of patients, they are also impacted by high rejection rates brought on by billing mistakes. A clinic frequently must fill the gap by charging patients more at the point of service when it can’t successfully charge insurance companies. Giving a patient an unexpected fee due to a refused claim can be embarrassing. Too much drama and ambiguity around your billing procedures might turn away customers or, worse still, convince them to postpone urgent medical care.
How to Avoid Medical Billing Mistakes in Your Practice?
Every successful medical practice needs a consistent stream of incoming income to maintain operations and spur expansion. It is a part of ensuring no billing mistakes harm the bottom line. Here are six useful suggestions for preventing errors in medical insurance billing.
- Follow developments in medical coding and billing.
Due to the numerous adjustments made to healthcare rules, new diseases, and novel treatments, medical billing codes are continually changing. As a result, staying current with new billing codes and practices is critical.
- Prevent double billing.
Medical billing and coding errors can be quite expensive for providers in the short and long term. Therefore, healthcare practitioners must make every effort to guarantee that medical coding services are 100 percent accurate. Making sure not to bill for assistance more than once is another approach to prevent mistakes. Even though it would seem like a self-explanatory process, it can happen simply if many people enter data. It’s essential to check each patient’s invoice to prevent more issues thoroughly.
- Avoid up- or under-coding unintentionally.
Upcoding and under-coding, both prohibited and might lead to penalties or criminal charges, are sometimes done to benefit a practice financially. Upcoding is adding codes to a patient’s bill for services that were not rendered; this is sometimes done to increase the overall amount owing to a provider. Under-coding occurs when codes are omitted from a patient’s bill, frequently to evade an audit.
However, there are instances where this might also occur unintentionally and not on purpose. This is typical for anyone who lacks medical billing company and coding knowledge, feels overburdened by the volume of claims they’re managing, or hasn’t kept up with the most current developments in the sector.
- Verify that your insurance is valid.
The primary cause of refused claims is usually an issue with the insurer. When a patient visits, a staff person frequently assumes that their insurance hasn’t changed. You might get into problems if it has changed, and no one verifies their eligibility.
You can make sure there are no insurance-related problems, such as terminated coverage, services that are not authorized, services that are not covered by the plan, or benefits that have been used up entirely by incorporating a step in your billing workflow that verifies the patient’s insurance at every visit.
- Submit your medical claims by the deadline.
It isn’t much you can do if claims are late if they are submitted after the deadline. The most challenging denials to appeal are those for timely submission.
Maintaining a running list of the most frequent ones required and assigning time-critical responsibilities to your personnel to audit unfiled claims are two ways to ensure you don’t miss these deadlines. A calendar event or regular reminder might be a useful solution to this issue.
- Verify again that the data has been input accurately.
It’s simple to make a common error when you’re significantly involved in medical billing and coding, especially if you also have other obligations. Some of the most typical ones to try to avoid are listed below:
- Incorrectly providing insurance, patient, or provider information (i.e., name, address, date of birth, policy numbers, etc.)
- Inputting ICD-10-CM codes that are either too long or too short
- Not inputting any codes in a particular claim
- incorrectly submitting CPT codes
Mistakes in the medical billing and coding process may be extremely costly for providers in the short and long run. As a result, healthcare practitioners must take every precaution to ensure 100 percent correctness in medical coding. You may maximize the money your practice generates in the future by using these suggestions to prevent medical billing mistakes. To use these suggestions properly, though, would undoubtedly take time and effort.